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The Stunning Rise in Plastic Surgery Shows a Psychological Crisis

In 2016 Americans spent $16.4 billion on cosmetic plastic surgery. What does that say about the health of our psyche? 

Over a billion phones in China are equipped with apps produced by Meitu, Inc. Launched in 2008, the signature app, also named Meitu (“beautiful picture”), is a basic photo-editing program. The inventors originally imagined it as a general-purpose app until they noticed user data. Teenage girls were by far the most engaged audience. Today the company is worth more than $6 billion. 

Meitu not only changed the perception of a generation in China, it also gave birth to a specific look: wang hong lian, “Internet-celebrity face.” Executives and users claim it to be an expectable backlash against the lack of individuality demanded by Communism for so long. And yet, critics reply, this has created its own form of uniformity. The average user spends forty minutes doctoring a photo before daring to release it for public inspection. A two-person photo demands at least an hour. 

Revenue is in part generated by cosmetic companies brandishing lucrative deals with wang hong elite, as well as by partnering with Meitu, Inc, to virtually stylize and then sell actual product to adoring fans—embedded links make shopping irresistible. But the craze has also created another trend: plastic surgeries in hopes of attaining the perfect “Internet-celebrity face.” 

While Jiayang Fan was reporting on Meitu for The New Yorker, she received a free consultation on what it would take to attain a wang hong face. By the end her face “resembled a military map.” The consultation is worth quoting in full, especially considering that Fan was effectively informed that, even with all of this work, she’d never achieve an Internet-worthy face. 

My jaw was too square, my cheekbones too broad, and my eyelids too droopy. My nose bowed outward—a “camel hump”—and I had a weak chin. After the half-dozen or so procedures that it would take to ameliorate these flaws, we could move on to smaller things, which could be dealt with by a combination of Botox (for my shrunken forehead, my jaw muscles, and the creeping crow’s-feet around my eyes) and filler (for my temples, the pouches under my eyes, my nasal folds, and my upper lip). The cost would be more than thirty thousand dollars. 

Americans also love work. We talk about it all the time: jobs growing the economy, getting this group of workers more work, technology alleviating certain forms of work in this sector, the work we put in at the gym, the work it takes to run a business and family. Yet there’s this other type of work so prominent in our culture, the work we pay for to hide the work we’re not willing to put in: the work associated with a cultural ideal detached from the emotions and psychology of what that work entails. 

This sort of work is more psychological than physical—we adore illusions, and any illusion that can temper the ravages of old age are considered to be worth the price. A little work here, some major work there, whatever works to stave off the tragedy of earthly decline. To stay relevant. To stay young.

We might not have Meitu, but Instagram celebrities with mutant bodies claim millions of fans. According to the American Society of Plastic Surgeons 2016 was its most successful year to date: 290,000 cosmetic breast augmentations; 131,000 face lifts; seven million Botox injections. Only laser hair removal and microdermabrasion were down from the prior year, but even those numbers—1.1 million and 775,000—are staggering. 

This trend cuts across all age groups. Once the domain of the aging, now Internet-celebrity faces (and butts and legs and breasts and arms) are available to all. There were 229,000 cosmetic procedures performed on teenagers in 2016, including the fast growing field: male breast reduction. The bulk of surgeries occurred in the 40-54 age group, the bulk of that being minimally invasive touch-ups like Botox. 

While 92 percent of patients were female, the 8 percent male ratio marks an increase as well. And the data are cross-cultural: the largest ethnic increase is Asian Americans at 6 percent, followed by Caucasians at 4 percent. There was no one-year change in African Americans, while Hispanic participation dropped by 2 percent. The fear of aging appears democratic even as our society seems less so.

These are one-year statistical increases. Trace over sixteen years and the numbers are even starker: 854 percent increase in Botox injections in women, 376 percent in men; 201 percent increase in buttock lifts in women, 537 percent increase in men; 5075 percent increase in upper arm lifts in women, while lower body lifts in men shot up 363 percent. These data are all regarding cosmetic, not reconstructive, procedures.

Total yearly cost of a little work? $16.4 billion. Projected to rise in 2017.

Fantasyland: How America Went Haywire is Kurt Andersen’s exhaustive 500-year history of an America that has produced creationism and reality television and a reality television president, a turn of events he could not even have foreseen when he began work on the book in 2013. He goes to great lengths to show how this detachment from what matters most has slowly, and then quickly, eroded our national conscience over the course of a half-millennium. 

Despite the tendency to look back at America’s founding as secular, Andersen documents the superstition that has pervaded this country since the first English immigrants dreamed of discovering the biblical garden of Eden, as well as sizable deposits of gold, in what came to be known as Virginia. The Plymouth Rock group was also seeking gold (and a quicker commute to Asia for trade). The fact that our schools’ textbook narrative has conveniently forgotten that in lieu of religious-freedom-seeking Pilgrims is indicative of our penchant for fantasizing. 

One modern manifestation of over overactive imaginations is what Andersen dubs the “Kids ‘R’ Us Syndrome.” Video games, fantasy sports, and adults dressing up for Halloween are products of the Reagan era, which he calls “ranging from the benign to the unfortunate.” He points to Michael Jackson who, while in residence at his fantastical Neverland Ranch, was having cosmetic surgery to look more and more like a child every few months. The nation followed suit. 

Around the same time, Andersen continues, the ubiquity of pornography made pubic hair obsolete and drove up the number of breast implants—one in twenty-five American women now have them. As trends become more extreme (like pornography itself), labiaplasty took root in Southern California, often so that a woman’s labia minora would not be noticed when they wore yoga pants. 

Americans began saying and wishfully believing about round-numbered ages that X is the new Y—thirty the new twenty, forty the new thirty, fifty the new forty, and so on. Yet in so many ways they all became the new twenty, the new fifteen…we really came to believe we were kids of all ages. 

We’ve long dreamed up escapes from organic reality through the invention of mythologies. From King Gilgamesh traveling the globe in search of the sacred plant that grants everlasting life to a California valley filled with code manipulators who drink chemistry all day—Soylent on the rocks, anyone?—the quest for eternity has never been far from view regardless of how elusive it always proves to be. Once doctors figured out how to physically represent these changes, the cost was never a concern.

Yet this frantic uptick in surgeries coincides with all-time high rates of anxiety and depression. The pool Narcissus couldn’t turn away from displayed a hazy outline of a human, dynamic and fluid as the rippling of lakes tends to be. Now we erase ripples, on our phone, on our flesh, without questioning the psychological cost those deletions demand.

The quest for presence—with our imperfections, with what we truly are as animals—seems even more evasive, a fact we often don’t realize until too late. Hospice dwellers desire connection, health, and freedom from pain, not fuller lips. While difficult to pinpoint the exact date we went from judging a person on the character of their actions to the character of their forehead, at some point we did, and that judgment is toxic. We pay the price every time we look into a mirror and say, “if only.” 

Wrinkles mark time like rivulets carve territory. In an era defined by femininist rights and an inspiring rush toward recognizing the unity of all races, falling victim to the greedy demands of our ego benefits no one. We should wear our skin proudly, as protectors of memories and champions of equality. To hate history is to loathe identity. That’s no way to live, no way to age, no way to die. Forgetting, Neruda wrote, is so long.


Derek is the author of Whole Motion: Training Your Brain and Body For Optimal Health. Based in Los Angeles, he is working on a new book about spiritual consumerism. Stay in touch on Facebook and Twitter.

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What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.

Northwell Health
Sponsored by Northwell Health
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Maps show how CNN lost America to Fox News

Is this proof of a dramatic shift?

Strange Maps
  • Map details dramatic shift from CNN to Fox News over 10-year period
  • Does it show the triumph of "fake news" — or, rather, its defeat?
  • A closer look at the map's legend allows for more complex analyses

Dramatic and misleading

Image: Reddit / SICResearch

The situation today: CNN pushed back to the edges of the country.

Over the course of no more than a decade, America has radically switched favorites when it comes to cable news networks. As this sequence of maps showing TMAs (Television Market Areas) suggests, CNN is out, Fox News is in.

The maps are certainly dramatic, but also a bit misleading. They nevertheless provide some insight into the state of journalism and the public's attitudes toward the press in the US.

Let's zoom in:

  • It's 2008, on the eve of the Obama Era. CNN (blue) dominates the cable news landscape across America. Fox News (red) is an upstart (°1996) with a few regional bastions in the South.
  • By 2010, Fox News has broken out of its southern heartland, colonizing markets in the Midwest and the Northwest — and even northern Maine and southern Alaska.
  • Two years later, Fox News has lost those two outliers, but has filled up in the middle: it now boasts two large, contiguous blocks in the southeast and northwest, almost touching.
  • In 2014, Fox News seems past its prime. The northwestern block has shrunk, the southeastern one has fragmented.
  • Energised by Trump's 2016 presidential campaign, Fox News is back with a vengeance. Not only have Maine and Alaska gone from entirely blue to entirely red, so has most of the rest of the U.S. Fox News has plugged the Nebraska Gap: it's no longer possible to walk from coast to coast across CNN territory.
  • By 2018, the fortunes from a decade earlier have almost reversed. Fox News rules the roost. CNN clings on to the Pacific Coast, New Mexico, Minnesota and parts of the Northeast — plus a smattering of metropolitan areas in the South and Midwest.

"Frightening map"

Image source: Reddit / SICResearch

This sequence of maps, showing America turning from blue to red, elicited strong reactions on the Reddit forum where it was published last week. For some, the takeover by Fox News illustrates the demise of all that's good and fair about news journalism. Among the comments?

  • "The end is near."
  • "The idiocracy grows."
  • "(It's) like a spreading disease."
  • "One of the more frightening maps I've seen."
For others, the maps are less about the rise of Fox News, and more about CNN's self-inflicted downward spiral:
  • "LOL that's what happens when you're fake news!"
  • "CNN went down the toilet on quality."
  • "A Minecraft YouTuber could beat CNN's numbers."
  • "CNN has become more like a high-school production of a news show."

Not a few find fault with both channels, even if not always to the same degree:

  • "That anybody considers either of those networks good news sources is troubling."
  • "Both leave you understanding less rather than more."
  • "This is what happens when you spout bullsh-- for two years straight. People find an alternative — even if it's just different bullsh--."
  • "CNN is sh-- but it's nowhere close to the outright bullsh-- and baseless propaganda Fox News spews."

"Old people learning to Google"

Image: Google Trends

CNN vs. Fox News search terms (200!-2018)

But what do the maps actually show? Created by SICResearch, they do show a huge evolution, but not of both cable news networks' audience size (i.e. Nielsen ratings). The dramatic shift is one in Google search trends. In other words, it shows how often people type in "CNN" or "Fox News" when surfing the web. And that does not necessarily reflect the relative popularity of both networks. As some commenters suggest:

  • "I can't remember the last time that I've searched for a news channel on Google. Is it really that difficult for people to type 'cnn.com'?"
  • "More than anything else, these maps show smart phone proliferation (among older people) more than anything else."
  • "This is a map of how old people and rural areas have learned to use Google in the last decade."
  • "This is basically a map of people who don't understand how the internet works, and it's no surprise that it leans conservative."

A visual image as strong as this map sequence looks designed to elicit a vehement response — and its lack of context offers viewers little new information to challenge their preconceptions. Like the news itself, cartography pretends to be objective, but always has an agenda of its own, even if just by the selection of its topics.

The trick is not to despair of maps (or news) but to get a good sense of the parameters that are in play. And, as is often the case (with both maps and news), what's left out is at least as significant as what's actually shown.

One important point: while Fox News is the sole major purveyor of news and opinion with a conservative/right-wing slant, CNN has more competition in the center/left part of the spectrum, notably from MSNBC.

Another: the average age of cable news viewers — whether they watch CNN or Fox News — is in the mid-60s. As a result of a shift in generational habits, TV viewing is down across the board. Younger people are more comfortable with a "cafeteria" approach to their news menu, selecting alternative and online sources for their information.

It should also be noted, however, that Fox News, according to Harvard's Nieman Lab, dominates Facebook when it comes to engagement among news outlets.

CNN, Fox and MSNBC

Image: Google Trends

CNN vs. Fox (without the 'News'; may include searches for actual foxes). See MSNBC (in yellow) for comparison

For the record, here are the Nielsen ratings for average daily viewer total for the three main cable news networks, for 2018 (compared to 2017):

  • Fox News: 1,425,000 (-5%)
  • MSNBC: 994,000 (+12%)
  • CNN: 706,000 (-9%)

And according to this recent overview, the top 50 of the most popular websites in the U.S. includes cnn.com in 28th place, and foxnews.com in... 27th place.

The top 5, in descending order, consists of google.com, youtube.com, facebook.com, amazon.com and yahoo.com — the latter being the highest-placed website in the News and Media category.
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A recent study gives new meaning to the saying "fake it 'til you make it."

Surprising Science
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